Diabetes (DM)
Conditions
Keywords
Diabetes Self-Management, Digital Health Intervention, Discharge Planning, Mobile Health
Brief summary
Diabetes mellitus is a chronic disease that requires continuous self-management to prevent complications and hospital readmissions. However, discharge planning in many hospitals is often delivered verbally and lacks structured follow-up after patients return home, which may lead to poor self-management behaviors. This study aims to evaluate the effectiveness of a digital discharge planning intervention delivered through a mobile application to improve self-management among patients with diabetes mellitus after hospital discharge. The intervention is based on the Chronic Care Model and includes educational materials, reminders, and monitoring tools related to seven dimensions of diabetes self-management. A randomized controlled trial with a parallel-group design will be conducted among patients with diabetes mellitus. Participants in the intervention group will receive digital discharge planning through a mobile application for 90 days after discharge, while the control group will receive standard discharge planning provided by the hospital. Primary outcomes include patient self-management behavior, while secondary outcomes include glycemic control and hospital readmission within 90 days.
Detailed description
Diabetes mellitus is one of the most prevalent chronic diseases worldwide and requires long-term self-management to maintain glycemic control and prevent complications. Effective discharge planning plays an important role in preparing patients to manage their condition independently after leaving the hospital. However, in many clinical settings, discharge planning is often delivered verbally and without structured follow-up, which may limit patients' ability to maintain appropriate self-management behaviors. This study develops and evaluates a digital discharge planning model delivered through a mobile application to support patients with diabetes mellitus after hospital discharge. The intervention is theoretically grounded in the Chronic Care Model and supported by nursing theories including Orem's Self-Care Deficit Theory, Watson's Human Caring Theory, and Pender's Health Promotion Model. The mobile application includes several features designed to support diabetes self-management based on the Diabetes Canada framework, including healthy eating, physical activity, blood glucose monitoring, medication adherence, problem solving, reducing risks, and healthy coping. The application provides educational materials, reminders, daily activity tracking, and feedback to encourage patient engagement and adherence to self-management practices. A randomized controlled trial with a parallel-group design will be conducted to evaluate the effectiveness of the intervention. Participants will be randomly assigned to either the intervention group receiving digital discharge planning through the mobile application or the control group receiving standard discharge planning provided by the hospital. The intervention period will last for 90 days following hospital discharge. The study will assess the impact of the digital discharge planning model on self-management behaviors, glycemic control, and hospital readmission among patients with diabetes mellitus.
Interventions
BEHAVIORALDigital Discharge Planning Application
A mobile health application designed to support diabetes self-management after hospital discharge, including education, reminders, and monitoring tools for 90 days.
BEHAVIORALStandard Discharge Planning
Participants receive standard discharge planning routinely provided by the hospital according to usual care procedures.
Sponsors
Universitas Muhammadiyah Surakarta
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
This study uses a single-blind design in which the outcome assessor will be blinded to the group allocation. Participants and investigators will be aware of the intervention due to the nature of the digital discharge planning intervention.
Intervention model description
Participants will be randomly assigned to either an intervention group receiving digital discharge planning through a mobile application or a control group receiving standard discharge planning provided by the hospital. The intervention will be conducted for 90 days after hospital discharge.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with diabetes mellitus. * Age 18 years or older. * Hospitalized patients who are preparing for discharge. * Able to use a smartphone and access the mobile application. * Willing to participate and provide informed consent.
Exclusion criteria
* Patients with severe complications requiring intensive care. * Patients with cognitive impairment or severe mental illness that may interfere with participation. * Patients who are unable to operate a smartphone or mobile application. * Patients who decline to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in diabetes self-management score | Baseline to 90 days after hospital discharge | Diabetes self-management will be assessed using an adapted Indonesian version of the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire consisting of 21 items across seven domains (healthy eating, physical activity, blood glucose monitoring, medication adherence, problem solving, risk reduction, and healthy coping). Each item is scored on a 5-point Likert scale (1-5) reflecting frequency of behavior during the past 7 days. Total scores range from 21 to 105, with higher scores indicating better diabetes self-management behavior. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in HbA1c level | Baseline to 90 days | Glycemic control will be assessed by measuring glycated hemoglobin (HbA1c) levels before the intervention and at the end of the 90-day follow-up period. |
| Hospital readmission within 90 days | Within 90 days after hospital discharge | Hospital readmission due to diabetes-related complications within 90 days after discharge will be recorded from hospital records. |
Countries
Indonesia
Contacts
CONTACTRirin Kartika Novitasari
Outcome results
None listed